Individuals Covered By Both Medicare and Medicaid (Dual Eligible Members)
AHCCCS continues developing integration initiatives to increase alignment and improve service delivery for individuals covered by both Medicare and Medicaid. These individuals, commonly referred to as “dual eligible members,” navigate multiple health systems to receive care. This health system fragmentation often results in poor communication, uncoordinated health care decisions and a lack of a patient-centered perspective. AHCCCS has moved toward increasing the coordination of health service delivery between these two health programs by contracting with Medicare Advantage Dual Special Needs Plans (D-SNPs) that are each affiliated with its partner AHCCCS Complete Care (ACC) Medicaid health plan. Requiring each ACC Medicaid health plan to offer a partner Medicare D-SNP promotes the enrollment or alignment of dual eligible members in the same health plan for both Medicare and Medicaid services to the greatest possible extent. Enrolling in specialized Medicare plans allows dual eligible members to receive all of their health care services, including prescription drug benefits, from a single, integrated health plan.
For more information regarding enrollment in an aligned Medicare D-SNP for 2023, please contact the plan you are interested in as listed on the AHCCCS CY2023 D-SNP Reference Table.